Predicting patterns of long-term CD4 reconstitution in HIV-infected children starting antiretroviral therapy in sub-Saharan Africa: a cohort-based modelling study.

Bibliographic Details
Title:	Predicting patterns of long-term CD4 reconstitution in HIV-infected children starting antiretroviral therapy in sub-Saharan Africa: a cohort-based modelling study.
Authors:	Marie-Quitterie Picat, Joanna Lewis, Victor Musiime, Andrew Prendergast, Kusum Nathoo, Addy Kekitiinwa, Patricia Nahirya Ntege, Diana M Gibb, Rodolphe Thiebaut, A Sarah Walker, Nigel Klein, Robin Callard, ARROW Trial Team
Source:	PLoS Medicine, Vol 10, Iss 10, p e1001542 (2013)
Publisher Information:	Public Library of Science (PLoS), 2013.
Publication Year:	2013
Collection:	LCC:Medicine
Subject Terms:	Medicine
More Details:	Long-term immune reconstitution on antiretroviral therapy (ART) has important implications for HIV-infected children, who increasingly survive into adulthood. Children's response to ART differs from adults', and better descriptive and predictive models of reconstitution are needed to guide policy and direct research. We present statistical models characterising, qualitatively and quantitatively, patterns of long-term CD4 recovery.CD4 counts every 12 wk over a median (interquartile range) of 4.0 (3.7, 4.4) y in 1,206 HIV-infected children, aged 0.4-17.6 y, starting ART in the Antiretroviral Research for Watoto trial (ISRCTN 24791884) were analysed in an exploratory analysis supplementary to the trial's pre-specified outcomes. Most (n = 914; 76%) children's CD4 counts rose quickly on ART to a constant age-corrected level. Using nonlinear mixed-effects models, higher long-term CD4 counts were predicted for children starting ART younger, and with higher CD4 counts (p10 y, ART should ideally be considered even if there is a low risk of immediate disease progression. Further exploration of the immunological mechanisms for these CD4 recovery profiles should help guide management of paediatric HIV infection and optimise children's immunological development. Please see later in the article for the Editors' Summary.
Document Type:	article
File Description:	electronic resource
Language:	English
ISSN:	1549-1277 1549-1676
Relation:	http://europepmc.org/articles/PMC3812080?pdf=render; https://doaj.org/toc/1549-1277; https://doaj.org/toc/1549-1676
DOI:	10.1371/journal.pmed.1001542
Access URL:	https://doaj.org/article/bf03b584a6a149f8ae35ce8e87d38d85
Accession Number:	edsdoj.bf03b584a6a149f8ae35ce8e87d38d85
Database:	Directory of Open Access Journals

More Details
ISSN:	15491277 15491676
DOI:	10.1371/journal.pmed.1001542
Published in:	PLoS Medicine
Language:	English